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General NPI Number Information
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NPI Number | 1861888745
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Entity Type | Individual
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Provider Name | AMIE RAE BRESSERT CNP
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Gender | Female
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 10999 REED HARTMAN HWY SUITE 215
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City | BLUE ASH
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State | OH
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Zip | 45242-8331
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Country | US
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Telephone | 513-745-9320
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Fax |
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Provider Business Mailing Address
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Address Line | 4657 CARDINAL DR
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City | CINCINNATI
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State | OH
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Zip | 45244-1140
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Country | US
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Telephone | 513-207-0423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | COA.17248-NP
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License Number State | OH
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